Healthcare Provider Details

I. General information

NPI: 1518340538
Provider Name (Legal Business Name): ELISE LILLIAN JOHNSON-GRIFFIN MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W PASSAIC ST STE 28
ROCHELLE PARK NJ
07662-3105
US

IV. Provider business mailing address

151 W PASSAIC ST STE 28
ROCHELLE PARK NJ
07662-3105
US

V. Phone/Fax

Practice location:
  • Phone: 201-431-5505
  • Fax:
Mailing address:
  • Phone: 201-431-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberSW131500
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06045100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: